Viruria in Adult Hemorrhagic Cystitis Patients Following Allogeneic Hematopoietic Stem Cell Transplantation and Implication of Antiviral Treatment.
10.5045/kjh.2007.42.2.114
- Author:
Sung Yong KIM
1
;
Jong Wook LEE
;
Kyu Man LEE
;
Byung Sik CHO
;
Ki Seong EOM
;
Yoo Jin KIM
;
Seok LEE
;
Chang Ki MIN
;
Hee Je KIM
;
Seok Goo CHO
;
Dong Wook KIM
;
Woo Sung MIN
;
Chun Choo KIM
Author Information
1. Catholic Hematopoietic Stem Cell Transplantation Center, St. Mary's Hospital, The Catholic University of Korea, Korea. jwlee@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Viruria;
Cystitis;
Hematopoietic stem cell transplantation;
Cidofovir
- MeSH:
Adult*;
BK Virus;
Cystitis*;
Hematopoietic Stem Cell Transplantation*;
Hematopoietic Stem Cells*;
Humans;
Incidence;
JC Virus;
Recurrence
- From:Korean Journal of Hematology
2007;42(2):114-121
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Viruria is frequently detected in patients who have had hemorrhagic cystitis (HC) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Urinary viruses, especially BK virus, have been suggested as a cause of HC following allo-HSCT, therefore antiviral therapy is emerging as a therapeutic approach for its treatment. METHODS: Adult HC patients who underwent allo-HSCT from January 2005 to March 2006 at a single institution were enrolled. We performed a PCR-based assay for BK virus, JC virus, and CMV virus in urine obtained from the patients to determine the incidence of viruria, and the type of virus detected in the urine, and the effect of treatment with cidofovir on HC. RESULTS: Of 155 patients that received allo-HSCT during the study period, 22 (14.2%) experienced HC. A viral study of urine obtained from 19 of these 22 patients revealed that 16 (84.2%) had viruria. Eleven patients had grade III-IV HC, 5 of which were treated with intravenous cidofovir. Three of the HC patients who underwent treatment responded to cidofovir, 1 had no response, and 1 had a complete response followed by recurrence. CONCLUSION: Most adult HC patients (84.2%) had viruria following allo-HSCT, however the response rate to antiviral therapy with intravenous cidofovir for the treatment of high grade HC (grade III-IV) was 80%. Therefore, antiviral therapy should be considered if high grade HC does not respond to hyperhydration and transfusional support.
